Promoting Prescription Accessibility and Affordability

Consumers are increasingly worried about the rise in prescription drug prices, and with good reason. In 2015 alone, the U.S. spent a record $425 billion on prescription drugs,IMS Health, National Sales Perspectives, Jan 2016; U.S. Census Bureau; U.S. Bureau of Economic Analysis which was 16.7 percent of all health care spending for that year.Department of Health and Human Services Observations on Trends in Prescription Drug Spending March 8, 2016

We know that cost concerns affect the choices consumers make about their care. In fact, 85 percent of consumers say they are personally concerned about the rising costs of prescription drugs,CVS Health Morning Consult Poll conducted July 14-16, 2016s and about one in five consumers reports delaying filling a prescription because of concern about their ability to afford it. Medication non-adherence can then add to the costs of health care because of increased hospitalizations and complications related to not taking medications as prescribed.

With 60 percent of U.S. adults regularly taking at least one prescription drug,­les/2016-PharmacyIndustry-Overview.pdf we are focused on finding solutions to the medication affordability challenge, including:

  • Unlocking Competition to Reduce Costs - At the beginning of 2017, there were more than 4,000 generic drugs in “pending approval” status at the Food and Drug Administration. CVS Health advocates for clearing out this backlog, and making increased competition a top priority. It is especially important to increase the flow of generics and biosimilars, which can result in cost savings for patients, taxpayers and the health system as a whole.
  • Looking at Value-Based Strategies – Across the health care industry, stakeholders are looking at implementing value-based drug purchasing models. These contracting strategies align a drug’s price to the evidence behind it, in terms of efficacy and/or patient outcomes. Setting prices based on the value of a good or service is not a new economic concept, and may result in increased savings for patients and payors.
  • Negotiating Discounts - CVS Caremark uses industry expertise to negotiate discounts with manufacturers. These discounts are passed on to pharmacy benefit manager (PBM) plan sponsors and can be used to reduce cost-sharing for consumers or to lower premiums. In addition, we have the capability for PBM clients to apply negotiated discounts at the point-of-sale, reducing a member’s out-of-pocket cost for a prescription when they are at the pharmacy counter.
  • Formulary Strategy - The guiding principles of our formulary strategy continue to be maintaining clinical integrity in order to provide access to clinically appropriate drug options for our millions of plan members, while reducing pharmacy costs for plan sponsors and members.

For more information on how CVS Health is working to ensure consumers have access to affordable medicines, check out our Rising Drug Prices information center. And to stay informed about the most talked-about topics in health care, register for content alerts and our bi-weekly health care newsletter.